ASSESSMENT Subjective: nahihiya akong lumapit sa ibang tao dahil dito sa ubo ko Objective: -depression -self-destructive feelings -paranoia

and loss of contact with real world -hopelessness -impulsiveness

NURSING DIAGNOSIS Risk for ineffective Coping

OBJECTIVES Coping as evidenced by often demonstrating ability to -Identify effective and ineffective coping patterns -Verbalize sense of control -Report decrease in negative feelings -Modify lifestyle as needed Social Support as evidenced by substantial reports of -Willingness to call on others for help -Emotional assistance provided by others

NURSING INTERVENTION - Provide an atmosphere of acceptance.

RATIONALE - Establishing rapport is essential to a therapeutic relationship and supports the client in self-reflection. Recognizing problems and sharing feelings is best brought about in an atmosphere of warmth and trust. - Factual information serves as a foundation for Patient to explore feelings and alternative coping strategies. Stressed clients often misunderstand facts and require frequent clarification so that appropriate conclusions can be drawn. Having valid information helps relieve stress.

EVALUATION Goal not met because of lack of time

- Provide factual information concerning the diagnosis, treatment, and prognosis.

- Arrange situations that encourage him autonomy. Give him as many opportunities as possible to make decisions/choices for himself. - Explore with his previous methods of dealing with life problems.

- Enhances a sense of control, personal achievement, and self-esteem.

- Present and past coping status assists both Patient and him wife in capitalizing on successful methods, identifying ineffective strategies, and developing new skills more appropriate to the present situation. Also determines risk for inflicting selfharm. - Open, nonthreatening discussions facilitate the identification of causative and contributing factors.

- Encourage verbalization of feelings, perceptions, and fears.

- Encourage to identify his own strengths and abilities.

- Assists to develop appropriate strategies for coping based on personal strengths and previous experiences. Improves selfconcept and sense of ability to manage stress. - Assessing family interaction serves as a basis for identifying Patients support systems or lack thereof. - Although adequate support systems may be available, Patient may not be using them or may be using them ineffectively. - Supporting patient in acknowledging changes in him appearance conveys acceptance and provides a foundation for him to begin to adjust.

- Observe the degree of family support.

- Determine barriers to using support systems.

- Involve wife, family, and friends in the care and planning.

- Discuss with concerned others how they can help.

- Family and friends are often willing but unsure how to help. Identifying specific strategies such as praise and encouragement during rehabilitation and healing will promote acceptance of change.